Management of Acute Myocardial Infarction During the COVID-19 Pandemic
Date
2020-04-20Journal
Catheterization and Cardiovascular InterventionsPublisher
John Wiley and Sons Inc.Type
Article
Metadata
Show full item recordAbstract
The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in the COVID-19 era. Cardiovascular manifestations of COVID-19 are complex with patients presenting with AMI, myocarditis simulating a ST-elevation MI presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury and the prevalence of COVID-19 disease in the US population remains unknown with risk of asymptomatic spread. This document addresses the care of these patients focusing on 1) the varied clinical presentations; 2) appropriate personal protection equipment (PPE) for health care workers; 3) role of the Emergency Department, Emergency Medical System and the Cardiac Catheterization Laboratory; and 4) Regional STEMI systems of care. During the COVID-19 pandemic, primary PCI remains the standard of care for STEMI patients at PCI capable hospitals when it can be provided in a timely fashion, with an expert team outfitted with PPE in a dedicated CCL room. A fibrinolysis-based strategy may be entertained at non-PCI capable referral hospitals or in specific situations where primary PCI cannot be executed or is not deemed the best option.Keyword
acute myocardial infarctionCOVID-19
emergency medical system
fibrinolysis
percutaneous coronary intervention
STEMI
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85083983304&doi=10.1002%2fccd.28946&partnerID=40&md5=82472a0ed6d3221f457d7f1ad830e4fd; http://hdl.handle.net/10713/12717ae974a485f413a2113503eed53cd6c53
10.1002/ccd.28946